HEALTH INFORMATION

Surgery: What to Expect

Topic Overview

Knowing what to expect before, during, and after surgery can help ease your fears. Knowledge can also help you take an active role in your recovery.

Being an active patient means asking questions and not agreeing to anything until you understand it and believe that it's for the best. Taking an active role also includes finding out about the cost of your treatment.

Minor surgeries

Minor surgeries that can be done in your doctor's office
or at a same-day surgery center usually take less than 2 hours, and you can
recover at home after the surgery. For these, you most likely will need only
oral pain medicines after your procedure. Examples of these types of surgeries
are:

Before Surgery

You will have an
appointment with your surgeon before your surgery. For this appointment, take
along a
list of questions about the surgery(What is a PDF document?) to help you understand your treatment.

Your surgeon
will explain why your surgery is needed, what it will involve, what its risks
and expected outcome are, and how long it will take you to recover. Talk to
your surgeon about any concerns you have about the surgery. You may also want
to ask about treatments you might try other than surgery.

Most surgery centers and
hospitals have a before-surgery form for you to fill out. This form usually includes
questions about your medical history and current health.

This
information helps the surgical team prepare for your surgery. They are trained
to provide you with safe care during your surgery. You most likely will complete the
form 1 to 3 days before your surgery.

Talking to your surgeon

Talk to your surgeon about what kinds of
surgery you have had in the past. Describe your recovery period, and be sure to mention any
problems you may have had.

Describe any health problems you have,
such as:

Diabetes.

Heart problems. Also tell your
doctor if you have a
pacemaker.

Lung problems, such as
COPD (chronic obstructive pulmonary
disease).

Sleep apnea.

Asthma.

Any allergies to
foods or any substance, including latex, tape, adhesives, anesthetics, or other medicines. You may also be asked whether any family members have had reactions
to anesthetics.

Any bleeding problems or use of blood-thinning
medicine, such as aspirin, clopidogrel, or warfarin.

A current—or recent—cold, flu, or fever.

It's important to
tell your doctor about any tobacco, alcohol,
illegal drugs, or medicines you use. This includes over-the-counter medicines, vitamins, and supplements, such as
St. John's wort and diet aids. Your use of substances or medicines may affect your reaction
to
anesthesia or pain medicines.

Talk about
any physical restrictions you have, such as an artificial joint or limited
range of motion of your neck, arms, or
legs.

Let your doctor know if you have any metal implants or
fragments in your body.

Tell your surgeon if you
are or might be pregnant.

Tests before surgery

Before surgery, your surgeon may also ask you to see your regular doctor for an exam and possibly for tests. A surgeon may ask this to make sure that surgery is not likely to be too hard on you. The tests may include:

You may also be scheduled for other tests, such
as
X-rays or an
electrocardiogram (EKG), if your surgeon thinks they
are needed before your surgery.

Your surgeon may include other
doctors in your care, depending on your other medical conditions. For example,
if you have heart problems, your surgeon may discuss your care with a
cardiologist.

If you have many medical problems, your
regular doctor may do your physical exam before surgery. To help make sure that
no problems are missed, you may find it helpful to have a doctor who knows you well
do this exam and your medical history.

Donating blood

If you will need blood
during your surgery, you may wish to donate your own blood. This has to be done several weeks before your
surgery.

Talking to a nurse before surgery

Many hospitals or surgery centers have a nurse who will
meet with you or call you at home a few days before your surgery. This nurse
makes sure all your forms and tests are complete before your scheduled surgery.
The nurse also:

Makes sure the date and time of your surgery
are correct.

Talks about when you should stop eating and drinking
before surgery.

Answers any questions you may have.

Preparing for surgery

Before your surgery, your surgeon
or nurse will remind you to do the following:

Bring any
X-rays or other tests that you may have.

Follow the instructions exactly
about when to stop eating and drinking. If
your doctor has told you to take medicines on the day of surgery,
do so using only a sip of water.

Bring what you will need after surgery, such as
your inhaler if you have
asthma or a cane if you use one. Also bring your
insurance information.

If you are having same-day surgery, arrange for someone to take
you home. And make sure you have someone stay with you for the first 24
hours.

Shower the morning of surgery, but don't use any perfumes,
colognes, or body lotion.

Remove all nail polish and body jewelry, such as
piercings.

Just before surgery

When you arrive for
your surgery, your nurse will:

Check your name, your birth date, and your
signed consent for surgery. Your nurse will also check the correct body area
for your surgery. If you have any last-minute questions, ask to discuss them
with your surgeon.

Make sure you have not had anything to eat or drink
for the length of time your surgeon told you.

Check your medical chart for any allergies you have and any
medicines you take.

Your nurse will also explain to you what will happen and will reassure you to help you
stay calm. He or she may go over a
pain scale, which may be used to help see how you are doing
after surgery.

Your surgeon or the surgical team may also give you
some information on what will happen after surgery, such as whether you will
have special equipment, like another IV, a urinary catheter, or wound
drains.

The nurse will have you:

Urinate and change into a hospital
gown.

Remove any dental work, such as dentures or
plates.

Remove any hearing or visual aids, such as
hearing aids or contact lenses.

Pre-surgery medicines

The nurse will give you any medicines ordered by your surgery team, such as:

Medicines ordered by
the
anesthesiologist during his or her visit with you
before surgery. These medicines will help you relax.

An
intravenous (IV) line in your arm or hand, if ordered
by your surgeon or anesthesiologist. This gives you fluids and medicines before, during,
and after your surgery.

Family and friends

The nurse will tell your family or friends how long you
will be in surgery and in the recovery area. The nurse will also let them know where they can wait during your
surgery.

The nurse will answer any questions you or your family members
have about your surgery. Tell the nurse who you want to be contacted right after
your surgery to talk about how the surgery went.

During Surgery

A special surgical team helps the surgeon
with your surgery. This team usually includes:

A surgical technician (scrub), who passes
instruments to the surgeon.

A
registered nurse, who helps in many ways and writes
the details of your surgery in your medical chart.

A nurse
anesthetist or
anesthesiologist, who gives you medicines and monitors
your vital signs.

Other medical personnel, such as an X-ray
technologist, who may be needed for your surgery.

Another surgeon
to help your primary surgeon, if needed.

In university or teaching hospitals, doctors with different
levels of surgical training may watch or help with your surgery. But your
surgeon will be in charge.

The surgical team is trained to provide
you with safe care during your surgery. Before they start, the team members will double-check your name, what type of surgery you are there for, and what part of your body is to be operated on.

Anesthesia

If you are having
general anesthesia, a breathing tube (endotracheal tube) is placed in your windpipe or a
special airway (laryngeal mask airway, or LMA) is placed in the back of your
throat to help you breathe during the surgery. To learn more, see the
topic
Anesthesia.

Keeping things sterile

The place on your skin where the
incision will be is washed with a special solution to remove bacteria. All
instruments used during your surgery are sterilized to reduce your risk of
infection.

Pain control

Pain control is an important concern. Near
the end of your surgery, your surgeon may inject a long-acting pain medicine at
the site of your surgery to decrease your pain for 6 to 12 hours after
surgery.

In the recovery area

Right after surgery, you will
be taken to a recovery area where nurses will care for and observe you. A nurse
will check your vital signs and bandages. He or she will also ask about your
pain level.

When you wake up, you may have a small
tube just below your nose that supplies oxygen to your lungs.

You will most likely stay in the recovery area
for 1 to 4 hours. Then you will be moved to a hospital room or you will go
home. You may receive medicine or fluids through your vein (intravenous, or IV) during your time in the
hospital.

After Surgery

If you go home the same day

Relief of any nausea or vomiting is an important
concern. If you will be going home the same day, you will need to drink fluids
without vomiting, be upright without fainting, and urinate on your own before
you will be sent home.

If you go home, the nurse will give you instructions on
breathing and exercises to help prevent any problems. For most minor surgeries,
the nurse will encourage you to be as active as possible to prevent these
problems.

Your doctor may give you medicine for pain.

If you stay in the hospital

Pain control remains an important concern after surgery. Inflammation or nerve injury from the surgery can cause pain. Your doctor may give you more than one medicine for pain. Often, opioids are given. In some cases, you may use a pain pump so that it's easy to get pain medicine right when you need it.

Typically, before you go home your doctors and nurses will make sure that:

You can breathe using your full lung
capacity.

You are able to eat.

Your pain has been controlled so that it doesn't interfere
with your physical activities.

Risks of surgery

The most common
problems after surgery are
pneumonia, bleeding, infection, clotted blood
(hematoma) at the surgery site, and reactions to the anesthesia.

In the first 48 hours after surgery, the most likely risks are bleeding
and problems with your heart or lungs.

From 48 hours to 30 days
after surgery, the most common risks are infection, blood clots, and problems
with other body organs, such as a
urinary tract infection.

Anesthesia side effects

Along with putting you to sleep during surgery, anesthesia can have side effects. Two of the most unpleasant ones are nausea and
constipation.

While nausea will soon wear off, your constipation can leave you
uncomfortable for several days after your surgery. Your nurses can give you a
medicine to promote bowel movement. But eating may actually be the most
effective means of ending constipation, because food will push waste through
your system.

Ready or not?

You may meet most of the criteria to go home but may not be able to
do certain things well enough to go home. In this case, you may go to a type of
assisted-living facility instead of to your home. Nurses and rehabilitation
specialists at an assisted-living facility can help you work toward getting
home.

Home care instructions

You will most likely go home with a sheet of
instructions including whom to contact if you have a problem.

A nurse will go over these instructions with you. He or
she can also help arrange for any care you will need when you go home. This may
include nursing care or visits from other health care workers.

Your instructions will include:

Which medicines you are
to take and when, including medicines you take regularly.

The level
of activity that is safe for you to do. For example, the instructions will
likely list when it is okay to drive, how much you can walk each day, how much
weight you can lift, and what other things you can do as you recover. For most
minor surgeries, you will be encouraged to be as active as possible to avoid
problems.

What foods to eat and how your bowel and
urinary habits may be different.

Incision care

The best way to bathe and protect your wound, such as how
to cover the area if needed and when it is safe to shower and let the incision
get wet.

How to care for and change your surgical
dressing.

What clothing to wear to avoid rubbing your incision
area.

What symptoms to look for that may be a problem.
Signs of a skin infection, such as a fever, increased
pain, or increased drainage, need to be checked by your surgeon. Mild swelling
and redness around the incision area is normal after surgery.

Follow-up

Your instructions will include when to have a follow-up appointment with
your surgeon. Your surgeon will want to talk to you before your follow-up
appointment if:

You aren't sure about your home-care
instructions. Ask right away if you have any questions about wound care or
drainage.

You develop a symptom or problem that you don't know how
to handle.

You develop an unexpected symptom or
problem.

You aren't able to take your
medicines.

When should you call your surgeon?

Call 911 or other emergency services right away if you have these symptoms:

Signs of shock, such as passing out, or feeling very dizzy, very weak, or less alert

An increase in
leg swelling. This may be a sign of
deep vein thrombosis, a condition that can be very serious if not treated.

Your recovery from surgery may be different from what
your surgeon expected. Other symptoms or problems may develop after your
surgery, even when you follow your surgeon's instructions. This can be very
frustrating.

Be sure to call your surgeon if you have an
unexpected symptom or problem, including:

Nausea and vomiting. If you aren't able to
keep fluids down, you may become
dehydrated.

Difficulty
swallowing.

Pain that doesn't go away after you take your pain
medicine.

A temperature higher than
101°F (38°C).

Difficulty urinating or having a bowel
movement.

Loose stitches or an open surgical wound.

Pus draining from your wound or red
streaks.

A rash.

Other Places To Get Help

Organization

Agency for Healthcare Research and Quality (AHRQ): Having Surgery? What You Need to Know (U.S.)

Topic Contents

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